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Resolving Myopic Foveoretinal Detachment by Fovea-Saving Internal Limiting Membrane Peeling: A Case-Series Report

Open Journal of Ophthalmology 2023年第1期13卷 106-121页

作者： Miguel Angel Quiroz-Reyes Erick Andres Quiroz-Gonzalez Miguel Angel Quiroz-Gonzalez Virgilio Lima-Gomez Oftalmologia Integral ABC Retina Department Medical and Surgical Assistance Institution (Nonprofit Organization) Affiliated with the Postgraduate Studies Division at the National Autonomous University of Mexico Mexico City Mexico Juarez Hospital Public Assistance Institution (Nonprofit Organization) Mexico City Mexico

Background: In highly myopic eyes, myopic foveoschisis (MF), the earliest stage of myopic traction maculopathy (MTM), is present in up to 34% of patients with pathologic myopia and slowly progresses to form foveoretinal detachment (FRD) or macular hole (MH) with or without macular hole retinal detachment (MHRD) as a part of its natural history. Aim: To describe the microstructural and functional results in three highly myopic eyes that underwent macular surgery for early-stage MTM. The last postoperative structural findings were correlated with the final vision and macular automated microperimetry evaluation. Methods: We retrospectively reviewed three highly myopic eyes that underwent successful fovea-saving internal limiting membrane (FS-ILM) macular surgery for chronic FRD at Oftalmologia Integral ABC, Mexico City, Mexico. We performed postoperative multimodal microstructural and functional evaluations, including SD-OCT, SS-OCT, and microperimetric macular examinations. Results: There was a substantial difference between best-corrected visual acuity (BCVA) preoperatively and postoperatively in all three cases. Postoperative surgery was associated with significant improvement in visual acuity confirmed using a paired-sample permutation test. The mean presurgical BCVA value (LogMAR;mean ± SE) was ~0.83 ± 0.15, and the postsurgical value was ~0.43 ± 0.52 (P = 0.00065). The myopic foveoretinal detachment evaluation was ~7.3 ± 3.5 months, with a mean postoperative follow-up time of ~14 ± 4.08 months. Furthermore, postoperative multimodal imaging tests demonstrated an abnormal microstructural foveal SS-OCT pattern without evidence of macular hole (MH) development at the postoperative follow-up. Macular microperimetry confirmed a subclinical reduced macula threshold sensitivity with an anomalous retinal sensitivity analysis map and a stable central foveal fixation site. Conclusions: Even with the successful microstructural disappearance of myopic macular detachment, the

关键词： automated microperimetry Myopic Foveoretinal Detachment Myopic Foveoschisis Myopic Macular Hole Myopic Traction Maculopathy Posterior Staphyloma

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